How to Improve Wound Healing in Periodontal Plastic Surgeries?

Objectives: Wound healing is crucial in determining the esthetic outcome of any surgerical procedure, and can represent a challenge in periodontal plastic surgeries, especially those that heal by secondary intention, such as surgical gingival depigmentation. Therefore, there has been termendous efforts to improve wound healing either through modifications of surgical techniques, or by application of different materials that boost wound healing. The present study aimed to evaluate effect of oxygen releasing oral gel versus anti-oxidant gel on wound healing, pain, patient satisfaction after surgical gingival depigmentation procedures.
Methods: 24 patients were randomly and equally allocated into 3 groups; group A received oxidizing gel+Coe Pak, group B received antioxidant gel+Coe Pak, group C (control) received Coe Pak only, postsurgically.
For all groups, conventional scalpel gingival depigmentation was performed in the anterior maxillary or mandibular region from right premolar area to the left premolar area, from the mucogingival junction to the base of the interdental papilla, while maintaining gingival contours and leaving a thin layer of connective tissue over the alveolar bone preserving the periosteum.Afterwards, the gel and/or dressing material was applied. The wound healing was assessed for one month at weekly interval, VAS score and patient satisfaction were recorded.
Results: Intragroup: For group A and B, posthoc pairwise comparisons showed significantly higher wound healing index at the third (5,5) and fourth weeks (5,5), respectively. than earlier intervals. Group B showed statistically significantly higher healing index in the second week compared to the first week (4, 3.50±1) in contrast to group A (4±1,4), respectively. For group C, all comparisons were statistically significant at all intervals (P value<0.001).
Intergroup: For the first, second and third weeks, there was a statistically significantly higher healing index and VAS scores between groups, in favor of group A and B (P<0.5). However, after the fourth week all cases, in all groups showed complete healing with a score of 5.
Conclusions: The use of oxidizing gel or antioxidant gel as an adjunct to Coe Pak after periodontal plastic surgery fastens wound healing and decreases postoperative pain.